Kiki Fehling was enjoying a dance class she regularly attended when the weirdest thing happened.

Trying to lift her arms above her head, she couldn't do it.

Moments earlier, she had another bizarre sensation – like a metal bar was squeezing her chest, making it difficult for her to breathe.

Fehling was 29 and living in New York while finishing her doctoral degree in clinical psychology. She'd never had any medical issues, so she assumed this was a panic attack, even though she'd never experienced one.

She left the room to sit in the hallway. She practiced paced breathing to calm herself. Her symptoms persisted.

She went to the door and motioned for her friend, Agusta Patton, to come outside.

"Something's wrong," Fehling told her. Patton dialed 911.

Paramedics seemed skeptical that something serious was happening to a young, seemingly healthy woman during a dance class. As Fehling herself had done, they assumed she was having a panic attack.

Eventually, they started running tests. An electrocardiogram – the test with the squiggly lines that shows the heart's electrical activity – showed Fehling was having a heart attack.

At the hospital, more tests revealed a hole in Fehling's heart. It had been there since birth and had never caused her any problems.

Doctors also determined that the blockage that caused her heart attack likely stemmed from a blood clot in her calf breaking off during the dance class, then traveling up to her heart and going through the hole.

Doctors closed the hole in Fehling's heart and prescribed her a blood thinner to help prevent future clots. She went home after a week.

While her physical recovery went smoothly, her emotional recovery was more difficult.

In the months after her heart attack, Fehling dealt with fear and anger. She was scared of exerting herself even the tiniest bit. Merely rolling out of bed each morning prompted her heart to race. She couldn't even walk to the grocery store without feeling it would cause another heart attack.

Fehling also struggled with memories of caregivers assuming her blood clot was substance-, diet- or stress-related.

"It was very shame-inducing because they made me feel as if it was my fault, when really I'm not sure what I could have done differently," she said.

Then there was the depression caused by the grief over losing the sense of being a young, healthy person. At times she felt an overwhelming sense of loss of self, safety and control. It led to loneliness, too.

"That's the part that lasted the longest for me," she said.

Patton underestimated just how traumatizing her friend's heart attack was.

"Kiki is so strong and capable, and she didn't have any external injuries or limitations," Patton said. "It was easy for me and other people to forget it happened — or, rather, forget what it could mean to the person it happened to. I sound as bad as the paramedics. But that's my biggest learning, a reminder that people all have these things happening inside of them and even if they are not always talking about them, they matter so much."

As a clinical psychologist, Fehling – who now lives in Northampton, Massachusetts – specializes in a therapy called dialectical behavior therapy, or DBT, a treatment that combines mindfulness and behavioral strategies to help individuals manage intense emotions, improve relationships and reduce harmful behaviors.

Fehling is grateful she knew about DBT at the time of her heart attack. Her familiarity with dozens of coping skills, such as paced breathing, helped her get through it all.

"Even if you're dealing with emotional stuff, there's concrete tools that can help you, and you can get back to normal life," she said.

Fehling believes the combination of her personal and professional experiences "made me a better therapist and teacher."

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Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.